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Objective To discuss the feasibility and value of indocyanine green combined with methylene blue in sentinel lymph node biophy (SLNB) for patients with breast cancer.Methods 196 breast cancer patients who received surgery were studied.SLNB was performed by indocyanine green combined with methylene blue .Frozen section was performed,followed by conventional histopathology .The evaluation criterion of Louisvill University on SLNB was adopted to judge the detection rate ,accuracy rate,sensitivity,false negative rate.Results Among the 196 cases,196 cases were detected with SLN ( detection rate was 100.0%).SLN was all stained in 196 cases. Furthermore,56 cases had ALND metastasis,140 cases had no metastasis,and the sensitivity was 91.8%(56/61). The SLN and ALN fully complied with pathological examination in 191 cases,and the accuracy rate was 97.5%(191/196).Five cases were false negative,and the false negative rate was 8.2%(5 /61).No case was false positive.The total SLNs was 705,and average number of detected SLNs was 3.59 pieces(2-6 pieces).The average ALN was 17.66 pieces(12-26 pieces).Conclusion With the advantages of real-time visual,precise positioning,no radio-active pollution and reduce the operation difficulty ,indocyanine green joint methylene blue as lymph tracer shows high detection rate,accuracy when it is used for SLNB in patients with breast cancer ,it is worthy of clinical application.
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Objective To explore the relationship of molecular biology characteristic and the treatment outcome,and influence factors of neoadjuvant chemotherapy (NAC) in inflammatory breast cancer (IBC).Methods The clinicopathological data of 103 IBC patients who were treated with NAC from January 2005 to June 2013 were analyzed retrospectively.Immunohistochemical method was used to detect the expression of estrogen receptor (ER),progesteron receptor (PR),human epidermal growth factor receptor 2 (HER-2) and E-cadherin.The treatment outcome were evaluated.Results In 103 IBC patients,ER negative was 48 patients,PR negative was 51 patients,HER-2 positive was 45 patients,E-cadherin positive was 66 patients.The effective rate of chemotherapy was 72.8％ (75/103).The effective rate of chemotherapy in taxane-based group was significantly higher than that in anthracycline-based group [80.6％ (50/62) vs.61.0％(25/41)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in ER,PR,E-cadherin negative patients was significantly higher than that in ER,PR,E-cadherin positive patients [83.3％ (40/48) vs.63.6％ (35/55),82.4％ (42/51) vs.63.5％ (33/52),83.8％ (31/37) vs.66.7％ (44/66)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in taxane-based group with E-cadherin positive patients was significantly higher than that in anthracycline-based group with E-cadherin positive patients [77.5％ (31/40) vs.50.0％ (13/26)] (P ＜0.05).No correlation existed between the expression of HER-2 and the treatment outcome of chemotherapy (P ＞ 0.05).Conclusion ER,PR and E-cadherin negative patients with IBC is chemosensitive to NAC.The positive expression of E-cadherin may be an important factor of chemotherapy resistance.For the patients with E-cadherin positive,taxane-based chemotherapy regimen can achieve a better effective rate.
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Objective To study the effect of the ultrasound scalpel and electric knife in axillary lymph node dissection in modified radical mastectomy for breast cancer.Methods The clinical data of 429 patients with modified radical mastectomy for breast cancer were analyzed retrospectively.The axillary lymph node dissection in 178 cases were performed with the ultrasound scalpel (ultrasound scalpel group) and 251 cases were done with the electric knife(electric knife group).The blood loss,operative time,extubation time,the total amount of drainage,the incidence of seroma were compared.Results Two groups were successfully operated,no axillary vessels and long thoracic nerve,chest nerve injury.The blood loss,operative time,extubation time,the total amount of drainage in ultrasound scalpel group were significantly better than those in electric knife group [(98.0 ± 10.2) ml vs.(152.0 ± 11.5) ml,(125.0 ±9.6) min vs.(155.0 ± 12.3) min,(6.0 ± 2.1) d vs.(9.0 ± 4.3) d,(227.0 ± 10.6) ml vs.(319.0 ± 15.8) ml,P＜ 0.05 or ＜ 0.01].The incidence of seroma was no significant difference between two groups (P ＞ 0.05).Conclusions Using ultrasound scalpel in axillary lymph node dissection for breast cancer can significantly reduce operative time,and is consistent with less blood loss,less extubation time and the total amount of drainage.
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Objective To explore the clinical effect of carbon nanoparticle in the axillary sentinel lymph node tracer of breast cancer.Methods Fifty-seven patients with breast cancer underwent lymphatic tracing with carbon nanoparticle.The carbon nanoparticle suspension was subcutaneously injected around the areola (points at 4 o'clock) and tumor surface skin at 30 min before operation.The first lymph nodes blacked were named sentinel lymph node.Then performed modified radical mastectomy,observing the application value of carbon nanoparticle.Results The detection rate of sentinel lymph node was 98.2％ (56/57).The correct,sensitive and false negative rates were 98.2％(55/56),95.2％(20/21) and 4.8％(1/21),respectively.The false positive rate was 0.Conclusions The carbon nanoparticle suspension injection subcutaneously around areola in sentinel lymph node biopsy is helpful for accurately evaluating the axillary lymph node condition.Being simple to operate,accurate positioning,dyeing time and is worth popularizing.
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Objective To study the impact of the thymosin alpha 1 on the toxicity and celluar immune function during neoadjuvant chemotherapy of breast cancer.Methods 83 patients of Ⅱ b-Ⅲ a stage breast cancer were randomly divided into two groups:study group(40 patients,neoadjuvant chemotherapy of CEF combined with thymosin α 11.6mg HQD) and control group(43 cases,neoadjuvant chemotherapy of CEF alone).Results Rates of gastrointestinal reaction and bone marrow depression in study group were significantly lower than those in control group.The levels of CD3,CD4,CD4/CD8 and NK in study group were significantly higher than those in control group after chemotherapy.Conclusion The combination of thymosin alpha 1 and neoadjuvant chemotherapy for breast cancer can reduce the toxicity,improve the tolerance,enhance cellular immune function and improve the quality of breast cancer patient's life.